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COVID-19: Special Article
Changes in mental health of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
Bomi Park, Jihee Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh
Epidemiol Health. 2023;45:e2023019.   Published online February 14, 2023
DOI: https://doi.org/10.4178/epih.e2023019
  • 8,625 View
  • 367 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to study the effects of the coronavirus disease 2019 (COVID-19) pandemic on adolescents’ mental health in Korea.
METHODS
We used data from the Korea Youth Risk Behavior Survey 2018-2021 with 227,139 students aged 12-18 years. We estimated the differences in depressive symptoms, suicidal ideation, and stress perception before (2018-2019) and during (2020-2021) the pandemic, as well as before (2019), the first year (2020) of, and the second year (2021) of the pandemic. We also examined whether COVID-19 is statistically associated with mental health.
RESULTS
In both male and female adolescents, the prevalence of depressive symptoms, suicidal ideation, and stress perception was higher in the “not living with family,” “low household economic status,” and “self-rated unhealthy status” subgroups. The prevalence of depressive symptoms and stress perception was higher in middle school students. Adolescents were less likely to experience depressive symptoms (adjusted odds ratio [aOR], 0.86; 95% confidence interval [CI], 0.83 to 0.89), suicidal ideation (aOR, 0.80; 95% CI, 0.76 to 0.83), and stress perception (aOR, 0.76; 95% CI, 0.74 to 0.79) in 2020 than in 2019. However, there were more depressive symptoms (aOR, 1.06; 95% CI, 1.02 to 1.09), suicidal ideation (aOR, 1.15; 95% CI, 1.10 to 1.21), and stress perception (aOR, 1.19; 95% CI, 1.16 to 1.23) in 2021 than in 2020.
CONCLUSIONS
The COVID-19 pandemic had positive impacts on mental health of adolescents in its early stages but has had negative impacts as the pandemic continues. Attention should be paid to adolescents who are particularly vulnerable to the mental health effects of the pandemic.
Summary
Korean summary
The results from a nationally representative data showed that mental health in adolescents was improved in the first year of the COVID-19 pandemic compared to before the COVID-19 pandemic, but it was deteriorated in the second year of the pandemic compared to the first year.
Key Message
본 연구에서는 대규모 건강조사를 이용하여 코로나19가 장기화됨에 따른 영향을 평가하고자 하였다. 2018년-2021년 청소년건강행태조사에 참여한 만 12-18세 청소년 227,139 명을 대상으로 분석한 결과, 코로나19 유행 첫번째 해(2020년)에는 코로나19 유행 이전에 비해 정신건강이 개선되었으나, 코로나19 유행 두 번째 해(2021년)에는 코로나19 유행 첫 번째 해에 비해 청소년 정신건강이 나빠졌다. 또한 가족과 함께 거주하지 않는 경우, 가정 경제 수준이 낮은 경우, 본인이 건강하지 않다고 인지하는 경우에 더 취약하였다.

Citations

Citations to this article as recorded by  
  • Changes in Mental Health Among Adolescents in South Korea Before and After COVID-19: An Interrupted Time Series Analysis From 2015 to 2022
    Yeonjae Kim, Hyewon Park, YooWha Bhan, Donghwan Lee, Chang-Mo Oh, Weon Young Lee, Bomi Park
    Journal of Adolescent Health.2024;[Epub]     CrossRef
  • Excess mortality during the Coronavirus disease pandemic in Korea
    Changwoo Han, Hoyeon Jang, Juhwan Oh
    BMC Public Health.2023;[Epub]     CrossRef
  • A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study
    Mi-Sun Lee, Hooyeon Lee
    Psychiatry Investigation.2023; 20(11): 1086.     CrossRef
COVID-19: Special Article
Mental health of Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Hyunsuk Jeong, Suyeon Park, Jihee Kim, Kyungwon Oh, Hyeon Woo Yim
Epidemiol Health. 2022;44:e2022042.   Published online April 25, 2022
DOI: https://doi.org/10.4178/epih.e2022042
  • 19,480 View
  • 559 Download
  • 18 Web of Science
  • 19 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Coronavirus disease 2019 (COVID-19) and the associated social distancing, limited freedom, and fear of an uncertain future are expected to have substantial mental health effects. We investigated mental health responses in the community during the first year of the COVID-19 pandemic in Korea.
METHODS
We used 2016-2019 and 2020 data from the Korea National Health and Nutrition Examination Survey (KNHANES) to assess pre-pandemic and pandemic mental health status, respectively, in terms of perceived severe stress, depression, and suicidal plans. All analyses were gender-stratified. Pre-specified subgroup analyses were performed according to age, employment status, and household income.
RESULTS
The percentage of Korean adults with suicidal plans increased significantly from 1.3%p (95% confidence interval [CI], 1.1 to 1.5) in 2016-2019 to 1.8%p (95% CI, 1.4 to 2.1) in 2020. Individuals in their 20s and 40s showed a marked increase in suicidal plans (1.2%p; 95% CI, 0.0 to 2.3 and 0.9%p; 95% CI, 0.0 to 1.8, respectively). In men, depression and perceived severe stress increased significantly from pre-COVID-19 to 2020. There was a 2.4%p (95% CI, 0.8 to 4.0) increase in depression among standard workers and a 2.9%p increase in depression in individuals in the second-highest quintile of household income from 2016 and 2018 to 2020.
CONCLUSIONS
As COVID-19 continued, mental health issues such as suicidal plans, depression, and severe stress increased significantly in young men and people in the second-highest quintile of household income. Proactive community mental health efforts are needed to prevent increases in the suicide rate resulting from prolonged exposure to the COVID-19 pandemic.
Summary
Korean summary
코로나19 이전에 비해 코로나19 유행 첫 해 동안에 전체 인구에서 자살 계획 유병율이 유의하게 증가하였고 특히 20대-40대에서 증가 비율이 높았다. PHQ-9으로 측정한 우울증 유병율은 전체 남성에서 증가하였고 특히 30대 남성에서 증가 비율이 높았다. 코로나19 영향으로 자살 계획과 우울증과 같은 정신 건강 문제가 젊은 성인에서 크게 증가하였기 때문에 이러한 정신건강 문제가 자살률 증가로 이어지는 것을 방지하기 위해 국가적 차원의 체계적인 정책과 적극적인 지역사회 정신건강 중재가 필요하다.
Key Message
There was a significant increase in the prevalence of suicidal plan in the overall population during the first year of COVID-19 pandemic compared to pre-COVID-19. In particular, suicide plans increased among those in their 20s and 40s. The prevalence of PHQ-9 detected depression increased in all men, especially among men in their 30s. As mental health problems such as suicide planning and depression have significantly increased among young adults due to the impact of COVID-19, systematic policies at the national level and active community mental health interventions are needed to prevent these mental health problems from leading to an increase in suicide rates.

Citations

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  • Associations between discrimination experiences and symptoms of depression and anxiety among transgender adults: a nationwide cohort study of 269 transgender adults in South Korea
    Sungsub Choo, Ranyeong Kim, Hyemin Lee, Yun-Jung Eom, Horim Yi, Rockli Kim, Seung-Sup Kim
    Social Psychiatry and Psychiatric Epidemiology.2024; 59(5): 859.     CrossRef
  • Mental Health Status of New Police Trainees before and during the COVID-19 Pandemic
    Joungsue Kim, Jiyoung Yoon, Inah Kim, Jeehee Min
    Healthcare.2024; 12(6): 645.     CrossRef
  • Temporal dynamics of socioeconomic inequalities in depressive and anxiety symptoms during the COVID-19 pandemic: a scoping review
    Kiara Herrmann, Florian Beese, Lina Wollgast, Elvira Mauz, Christina Kersjes, Jens Hoebel, Benjamin Wachtler
    Frontiers in Public Health.2024;[Epub]     CrossRef
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    Dogo Armand Dago, Yu Pei
    Cogent Economics & Finance.2024;[Epub]     CrossRef
  • Exploring possible causes of lower‐than‐expected suicide rates in Taiwan and South Korea during the 2020–2021 COVID‐19 pandemic: a time trend analysis by sex, age, and method
    Chien‐Yu Lin, Minjae Choi, Yo Han Lee, Myung Ki, Chia‐Yueh Hsu, Shu‐Sen Chang
    Psychiatry and Clinical Neurosciences.2024;[Epub]     CrossRef
  • The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational Study
    Sumi Sung, Su Hwan Kim, Changwoo Lee, Youlim Kim, Ye Seul Bae, Eui Kyu Chie
    JMIR Public Health and Surveillance.2023; 9: e43003.     CrossRef
  • The Risk of Major Depressive Disorder Due to Cataracts among the Korean Elderly Population: Results from the Korea National Health and Nutrition Examination Survey (KNHANES) in 2016 and 2018
    Min-Jin Kang, Kyung-Yi Do, Nayeon Park, Min-Woo Kang, Kyoung Sook Jeong
    International Journal of Environmental Research and Public Health.2023; 20(2): 1547.     CrossRef
  • Prevalence of Mental Disorders and Associated Factors in Korean Adults: National Mental Health Survey of Korea 2021
    Soo Jung Rim, Bong-Jin Hahm, Su Jeong Seong, Jee Eun Park, Sung Man Chang, Byung-Soo Kim, Hyonggin An, Hong Jin Jeon, Jin Pyo Hong, Subin Park
    Psychiatry Investigation.2023; 20(3): 262.     CrossRef
  • The association mental health of adolescents with economic impact during the COVID-19 pandemic: a 2020 Korean nationally representative survey
    Hanul Park, Kang-Sook Lee
    BMC Public Health.2023;[Epub]     CrossRef
  • Obstructive sleep apnea related to mental health, health-related quality of life and multimorbidity: A nationwide survey of a representative sample in Republic of Korea
    Mee-Ri Lee, Sung Min Jung, Frances Chung
    PLOS ONE.2023; 18(6): e0287182.     CrossRef
  • Comparison of Mental Health between the Older People Living Alone and Older People Not Living Alone before and during the COVID-19 Pandemic: Using the 2019-2020 Korea Community Health Survey
    Kyong Sil Park, Yeojoo Chae
    Journal of Health Informatics and Statistics.2023; 48(2): 132.     CrossRef
  • The risk of obstructive sleep apnea is highly correlated with depressive symptoms among the Korean adults population: results from the 2020 Korea National Health and Nutrition Examination Survey
    Mi-Sun Lee, Hooyeon Lee
    BMC Psychiatry.2023;[Epub]     CrossRef
  • Gender Inequalities in Mental Health During the COVID-19 Pandemic: A Population-based Study in Korea
    Minku Kang, Sarah Yu, Seung-Ah Choe, Daseul Moon, Myung Ki, Byung Chul Chun
    Journal of Preventive Medicine and Public Health.2023; 56(5): 413.     CrossRef
  • Mental health status of individuals with diabetes in Korea before and during the COVID-19 pandemic: a comparison of data from the Korean national health and nutrition examination surveys of 2018–2019 and 2020–2021
    Hyejin Jung
    BMJ Open.2023; 13(10): e074080.     CrossRef
  • Assessment of burnout level among clinical dental students during the COVID-19 pandemic
    Cumhur Korkmaz, Sibel Dikicier, Arzu Atay
    BMC Medical Education.2023;[Epub]     CrossRef
  • The mechanisms of nature-based therapy on depression, anxiety, stress, and life satisfaction: examining mindfulness in a two-wave mediation model
    Minjung Kang, Yeji Yang, Hyunjin Kim, Songhie Jung, Hye-Young Jin, Kee-Hong Choi
    Frontiers in Psychology.2023;[Epub]     CrossRef
  • Changes in the management of hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: data from the 2010-2020 Korea National Health and Nutrition Examination Survey
    Yoonjung Kim, Suyeon Park, Kyungwon Oh, Hongseok Choi, Eun Kyeong Jeong
    Epidemiology and Health.2023; 45: e2023014.     CrossRef
  • Sadness, counseling for sadness, and sleep time and COVID-19 pandemic in South Korea: Rapid review and a post-hoc analysis
    Jungwoo Choi, Minji Kim, Min Seo Kim, Guillaume Fond, Laurent Boyer, Guillermo F López Sánchez, Elena Dragioti, Samuele Cortese, Ai Koyanagi
    Life Cycle.2023;[Epub]     CrossRef
  • Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak
    Ji-Young Kwon, Sang-Wook Song
    Epidemiology and Health.2022; 44: e2022101.     CrossRef
Original Article
Trends in health behaviors over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey
Soyeon Kim, Sunhye Choi, Jihee Kim, Suyeon Park, Young-Taek Kim, Ok Park, Kyungwon Oh
Epidemiol Health. 2021;43:e2021026.   Published online April 19, 2021
DOI: https://doi.org/10.4178/epih.e2021026
  • 15,146 View
  • 366 Download
  • 28 Web of Science
  • 23 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to examine the trends in health behaviors in Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS
The subjects were 96,408 adults aged 19 years or older who participated in the first (1998) through seventh (2016-2018) KNHANES health interview. The prevalence of health behaviors (cigarette smoking, alcohol drinking, and physical activity) and annual percent change (APC) were estimated using SAS and the Joinpoint program.
RESULTS
The prevalence of current cigarette smoking in men decreased by 2.8%p (APC= -2.8, p< 0.001) annually over the 20-year period, and the prevalence of exposure to secondhand smoke at home substantially decreased compared to 2005 (APC= -8.8, p< 0.001). Compared to 2005, the prevalence of current alcohol drinking in women, but not men, increased (APC= 2.0, p< 0.001), and the prevalence of binge drinking decreased in men (APC= -0.7, p< 0.001) and increased in women (APC= 2.4, p< 0.001). The prevalence of aerobic physical activity decreased from 2014 in both gendersd (p< 0.001). The prevalence of healthy behaviors practice (non-smoking, alcohol abstinence, and aerobic physical activity) was down-trending (APC= -5.3, p< 0.001), especially among women (APC= -6.4, p< 0.001).
CONCLUSIONS
Over the past 20 years, smoking behaviors improved. However, drinking behavior was unchanged and physical activity indicators markedly decreased. More active programs are necessary for improving health behaviors, which are major risk factors linked to chronic diseases.
Summary
Korean summary
국민건강영양조사(1998-2018) 자료를 활용하여 지난 20년간 성인의 건강행태를 분석한 결과 흡연율과 간접흡연 노출률은 지속적으로 감소하였고, 신체활동 실천율 또한 감소하였다. 월간음주율과 폭음률의 경우 남자는 큰 변화가 없었던 반면 여자는 모두 증가하였다.
Key Message
This study aimed to examine the trends in health behaviors in Korean population using data from the 1998-2018 Korea National Health and Nutrition Examination Survey (KNHANES). Over the past 20 years, the prevalence of cigarette smoking and exposure to secondhand smoke in Korean adults consistently decreased, as well as the prevalence of physical activity. There was no considerable change in men, whereas in women, the prevalence of alcohol drinking and binge drinking both increased.

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